Management of patients with unstable fracture or fracture-dislocation of thoraco-lumbar spine continues to be controversial. One area of disagreement involves spinal fusion with internal fixation for prevention of later spinal instability. Intemal fixation of the spine without fusion has been advocated in the treatment of the unstable thoraco-lumbar fracture or dislocation. During the period of January 1981 to March 1984, thirty-two patients underwent fixation by Harrington distraction rod without fusion for the treatment of thoraco-lumbar fractures. Eight cases among them had second operation for the removal of the Harrington rods in 13.4months after Harrington rod fixation and were followed up clinically and radiolagically for 1 year at the Department of Orthopaedic Surgery, St. Mary's Hospital, Catholic Medical College and Center. The rationales for this procedure were to minimize the number of permanently stabilized segments and to provide more spinal mobility. We have expected that spontaneous fusion of vertebral body occur by the prolonged immobilization with Hamngton distraction rods. After the Harrington rods, the average conection rate of kyphotic angle was 41.8% and average correction rate of height of collapsed vertebral body or displacement of vertebral body was 42.3% at one year follow up. Instrumentations in eight patient were removed at 13.4 months after the initial surgery and the patients were followed up for one year. At the time of removal of instrumentation, unilateral partial facetectomy was done for histologic examination of the facet joint which is above the lower Harrington hook in four patients. The average correction rate of kyphotic angle was 37.5% and the average correction rate of height of collapsed or displaced vertebral body was 40.6% at one year after the removal of H-rods. The range of spine motions were incresed gradually. But histologic findings of the immobilized facet joint revealed fibrillation, fissures, thinning of the normal cartilagenous surface, decreased cartilagenous cellularity, and vascular tidemark invasion which are characteristics of osteoarthritis. Through this study, we obtained following conclusions: 1. Immediate Harrington distraction rodding was effective for the anatomic reduction of the collapsed vertebral body. And it provided immediate spinal stability, and spontaneous fusion of vertebral body. 2. Prolonged immobilization of the spine by Harrington rods is believed to have deleterious effect on articular cartilage of the immobilized facet joint as the degenerative changes of the cartilage of the facet joint was consistently found in this study. And it was regarded as a predisposing factors in the development of symptomatic arthritis of the spine. 3. If a fractured and collapsed vertebral body can be reduced by Harrington distraction rods, a spontaneous fusion of vertebral body occur. Harrington rodding without fusion could be one of the useful surgeries for management of the fractures and fracture-dislocation of the spine.
Arthritis ; Cartilage ; Cartilage, Articular ; Causality ; Dislocations ; Follow-Up Studies ; Humans ; Immobilization ; Osteoarthritis ; Spinal Fusion ; Spine ; Zygapophyseal Joint

BACKGROUND: It is well known that a lacunar infarction has characteristic clinical features and a relatively good prognosis. However, the significance of lesions in the parent artery of patients with lacunar syndrome as regard to the prognosis remains unsettled. METHODS: Using the data of consecutive patients with their first ischemic stroke and were followed longer than 1 year, were divided the patients by their clinical features and the results of the work-up was as follows; (1) mismatching [MM] group; lacunar syndrome and the presence of parent arterial lesion, (2) large artery artherosclerosis [LAD]; non-lacunar syndrome and the presence of parent arterial lesion, (3) no determined etiology [NE]; non-lacunar syndrome without parent arterial lesion, and (4) small artery disease [SAD]; lacunar syndrome without parent arterial lesion. Patients with a potential source of embolism were excluded from this study. The prognosis and recurrence rate of patients with the MM group were compared with those of other groups. RESULTS: A total of 176 patients were included; 56 LAD, 62 SAD, 22 MM and 36 NE groups. An unstable hospital course was more frequently found in LAD than in the other groups. The recurrence rate of the MM group (23%) was significantly higher than that of SAD (2%), but was similar to that of patients with non-lacunar syndrome (LAD 16%, NE 28%). CONCLUSIONS: Among patients with lacunar syndrome, the prognosis of those with parent arterial lesions was different from those without lesions. Therefore, a systematic work up of the stroke mechanism may be important in patients with lacunar syndrome.
Arteries ; Embolism ; Humans ; Parents* ; Prognosis ; Recurrence ; Stroke ; Stroke, Lacunar*

BACKGROUND: Autism spectrum disorder (ASD) encompasses a range of disorders that are characterized by social and communication deficits and repetitive behaviors. This study evaluated the effect of methyl-6-(phenylethynyl)-pyridine (MPEP), an antagonist of the mGluR5 metabotropic glutamate receptor, on memory enhancement in the BTBR T+tf/J (BTBR) mouse strain, which has been recognized as a model of ASD. METHODS: The pharmacological effects of MPEP on memory and motor coordination were assessed using the Morris water maze and rotarod tests in BTBR and C57BL/6J (B6) mice. Furthermore, we performed morphological analyses of cerebellar foliation in BTBR and B6 mice using hematoxylin and eosin staining. RESULTS: MPEP-treated BTBR mice exhibited improved learning and memory in the Morris water maze test. MPEP administration also improved motor coordination in the rotarod test. However, no significant difference was observed regarding the numbers of Purkinje cells in the cerebella of BTBR versus normal B6 mice. CONCLUSION: This study suggests that the mGluR5 antagonist MPEP has the potential to ameliorate learning and memory dysfunction and impaired motor coordination in BTBR mice. These results further suggest that the BTBR mouse model may be useful in pharmacological studies investigating drugs that could potentially alleviate cognitive dysfunction in ASD.
Animals ; Child ; Autism Spectrum Disorder* ; Eosine Yellowish-(YS) ; Hematoxylin ; Learning ; Maze Learning ; Memory ; Memory, Short-Term* ; Mice* ; Purkinje Cells ; Receptors, Metabotropic Glutamate ; Rotarod Performance Test

Comamonas testosteroni and Acinetobacter guillouiae are gram-negative bacilli of low virulence that are widely distributed in nature and normal flora. Despite their common occurrence in environments, they rarely cause infectious disease. We experienced a case of septic shock by C. testosterone and A. guillouiae, and isolated them by 16S ribosomal RNA sequencing method from the blood cultures of a previous healthy female during postoperative supportive care. This is the first case of septic shock required ventilator care and continuous renal replacement therapy due to these organisms in Korea.
Acinetobacter* ; Bacteremia ; Comamonas testosteroni* ; Comamonas* ; Communicable Diseases ; Female ; Humans ; Korea ; Renal Replacement Therapy ; RNA, Ribosomal, 16S ; Shock, Septic* ; Testosterone ; Ventilators, Mechanical ; Virulence

No abstract available.
Liver* ; Neoplasm Metastasis*

BACKGROUND: Tracheal intubation commonly results in sympathetic stimulation manifested by increased heart rate and arterial blood pressure. This study was carried out to determine whether lightwand would result in less hemodynamic changes than direct laryngoscopy. METHODS: With informed consent, fourty healthy female patients scheduled of elective surgical procedures were randomly allocated into two groups; lightwand (LW) or direct laryngoscopy (DL) group. Mean arterial pressure (MAP) and heart rate (HR) were recorded upon arrival. Under a standardized anesthetic technique, the patients were intubated either with no. 3 curved blade direct laryngoscopy (DL group) or with lightwand (LW group). The MAP and HR were recorded before intubation and every 1 minutes following intubaion. Time to intubation (TTI) was also recorded. All patients were intubated by a same fourth grade resident. RESULTS: Fourty patients were studied. Every intubation was successed in first attempt. The TTI was significantly shorter in LW group. Even while there was no significant difference in HR changes, there was significant difference in the increase of MAP following intubation. The increase of MAP was significantly greater with DL than with LW. CONCLUSIONS: This study suggests that lightwand intubation requires shorter TTI and may give rise to less blood pressure change than direct laryngoscopy. So we found no difference in disadvantage and may offers advantage in terms of hemodynamic stability.
Arterial Pressure* ; Blood Pressure ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Informed Consent ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy* ; Surgical Procedures, Elective

PURPOSE: We report a case of candidal endophthlmitis developed in a patient with advanced gastric cancer who recently injured by flame burn. He was treated successfully with intravitreous and intravenous antifungal agents. METHODS: A 40-year-old man visited with complaints of decreased binocular visual acuity 7 weeks after third degree flame burn injury to 25% of body surface. Indirect ophthalmoscope showed findings of fungal endophthalmitis and upper gastro-intestinal endoscopic examination diagnosed of fungal esophagitis and advanced gastric cancer. He was treated with amphotericin B intranvitreously and fluconazole and amphotericin B intravenously. RESULTS: His visual acuity was improved to 20/50 (OD), 20/30 (OS) following 4 weeks after treatment and intraocular inflammation was decreased. After 5 months, he recovered his visual acuity as 20/25 (OD), 20/20 (OS), and had no inflammation in anterior chamber and vitreous.
Adult ; Amphotericin B ; Anterior Chamber ; Antifungal Agents ; Burns* ; Endophthalmitis* ; Esophagitis ; Fluconazole ; Humans ; Inflammation ; Ophthalmoscopes ; Stomach Neoplasms* ; Telescopes ; Visual Acuity

Opsoclonus is the involuntary, repetitive, rapid conjugate ocular movements occurring in all directions that are irregular in amplitude and frequency. The cause of opsoclonus are idiopathic, paraneoplastic or postinfectious. Opsoclonus of the postinfectious origin often accompanies other abnormal movements such as tremor, myoclonus and ataxia, and shows a relatively benign course with good response to steroid. Six patients who suffered from myalgia, chilling, fever, cough and generalized weakness fior one to two weeks prior to the admission, experienced visual disturbance, gait unsteadiness and clumsiness of the upper extremities,, Prominent opsoclonus, tremulous movements of trunk and limbs, and intermittent myoclonus were observed. These symptoms markedly improved several days following the use of ACTH or dexametasone.
Adrenocorticotropic Hormone ; Adult* ; Ataxia ; Cough ; Dyskinesias ; Extremities ; Fever ; Gait ; Humans ; Myalgia ; Myoclonus ; Ocular Motility Disorders* ; Tremor ; Upper Extremity

Opsoclonus is the involuntary, repetitive, rapid conjugate ocular movements occurring in all directions that are irregular in amplitude and frequency. The cause of opsoclonus are idiopathic, paraneoplastic or postinfectious. Opsoclonus of the postinfectious origin often accompanies other abnormal movements such as tremor, myoclonus and ataxia, and shows a relatively benign course with good response to steroid. Six patients who suffered from myalgia, chilling, fever, cough and generalized weakness fior one to two weeks prior to the admission, experienced visual disturbance, gait unsteadiness and clumsiness of the upper extremities,, Prominent opsoclonus, tremulous movements of trunk and limbs, and intermittent myoclonus were observed. These symptoms markedly improved several days following the use of ACTH or dexametasone.
Adrenocorticotropic Hormone ; Adult* ; Ataxia ; Cough ; Dyskinesias ; Extremities ; Fever ; Gait ; Humans ; Myalgia ; Myoclonus ; Ocular Motility Disorders* ; Tremor ; Upper Extremity

Choroid plexus papillomas are uncommon neoplasms of the central nervous system, accounting for 0.4% to 0.1% of all intracranial tumors. We present a choroid plexus papilloma in the trigone of the lateral ventricle in an 8 months old infant with hydrocephalus. We successfully controlled hydrocephalus and subdural fluid collection after total removal of the mass.
Central Nervous System ; Choroid Plexus* ; Choroid* ; Humans ; Hydrocephalus ; Infant* ; Lateral Ventricles* ; Papilloma, Choroid Plexus* ; Subdural Effusion